Why are the laws about contact lenses so strict?

In New Mexico, there is apparently a state law saying that if you’re a new to contacts, or for whatever reason need to switch brands, the doctor can’t just give you your prescription. They need to order a trial pair, have you come in to the office to pick them up, wear them for a week, and go back to the office for a ‘follow-up’, at which point the will finally give you your prescription.

What could possibly justify this, beyond an overly-aggressive lobbyist group? It’s not like they’re giving you morphine; they’re contact lenses. If there’s a problem the wearer is obviously going to notice and say something, because improperly fitted lenses are not comfortable. What’s the logic here?

(And no, I’m not bitter that through some magnificently shitty coincidental timing, the aforementioned law means I lost my health insurance before being able to order the lenses. Insurance would’ve paid for two years in full; now that’s five hundred bucks coming out of my pocket, which is a huge amount of money for me.)

Possibly lobbyist groups, but also because eye infections caused by improper contact use are really nasty things.

I’m not sure who would lobby for it. It’s not making the contact lens company any money*. IME the trial pair has been free. But, if you went ahead and bought two years worth and then found out they don’t work, you might not be able to return the unused lenses. Which would mean you (or the insurance company) would be out the $500. Not only that, but now you’ve got all these lenses that don’t fit. Alot of people will wind up wearing them anyways, or giving/sell them to other people.

*Well, I guess that depends on if the place that’s giving you the sample get’s their samples for free.

How often do those occur? I mean, I know people who have done some really nasty things with their contacts and were no worse for wear. Seriously, wearing one month contacts for five, never taking them off? Ugh.

Do you have a citation to an actual New Mexico state law that says such a thing? Often times state law is blamed for a lot of things that are really not in the law, just the practice of the company or doctor involved.

Not the contact lens companies, but the eye doctors. I suspect this rule is a reaction against online lens suppliers who sell directly to lens-wearers at cut-rate prices.

My understanding is that the doctors make a bundle from selling you lenses, much less so from just examining you. They resent people coming in and saying, “I need an exam and perscription. Lenses? No thanks. Bye!” They know that those people will rush off to some outfit like 1-800-CONTACTS to get their lenses. The doctor gets his one-shot examination fee while 1-800-CONTACTS gets a lifelong stream of purchases.

Unless the doctor is hoping for you to just buy them there, I think this would cost them money. Last time I got new contacts, I got a free pair for a week. It didn’t work, got a different size, tried those for a week, they worked. At that point I could have taken my script and walked. I didn’t, since I didn’t know better. But I’ll be going back in the next few weeks and I will. I’ve shopped around, found the cheapest exam/fitting at one place and the cheapest lenses at another. And at a difference of over $14/box if he wants to match the price that’s great, otherwise I won’t feel bad going somewhere else.

raises hand, sheeplishly

Even worse, they’re two-week disposables, and I must be nearing the 6-month mark. Yes…I’m really lazy.

So, uh, how bad is this for my eyes, exactly? They feel fine, so far.

Yep, Cite (pdf). At the bottom of the third page:

As the optometrist I saw explained, it’s only for lenses you haven’t had before. Renewing your prescription* without a trial is fine. New lenses or new brands of lenses require a trial.

*IMO it’s idiotic that lens prescriptions are required to expire after x amount of time, but for some reason no one ever asks me before making these decisions.

It’s something of a lottery. But abusing your contacts will get you in trouble sooner rather than later.

Remember the hideous eye fungus that people were getting a while back? It wasn’t the sterile solution’s fault–it was because people were re-using dirty solution. (Golly, folks, it’s not that expensive.)

I became suddenly and violently allergic to my contacts for no apparent reason. No contacts for two years, now I can wear a new kind for about 6 hours at a time. I’ve also had mysterious minor eye infections, though I’ve never abused my contacts.

My BIL ripped a piece of his cornea off his eyeball (it stuck to the lens), and no longer wears contacts at all; it’s too painful.

Are the rules really that recent?

Whether the doctors are the source of the rule or not, they most certainly do get pissy about your not buying the lenses from them, and quite honestly, it’s worked to make me less inclined to see them on an annual basis. I’m sorry, but I have a budget I need to stick to. Paying the doc twice what I’d have to pay an online provider just for the luxury of a few small bottles of “free” contact solution really doesn’t cut it.

My wife is an Optometrist. From what I’ve seen, the majority of people are pretty much unable to wear contacts properly. I’m sure this is not the case at the SDMB because this is an intelligent group, but people will wear 2 week contacts for 3 months, or sleep in them all the time. I’ve seen patients who almost lost their corneas because of this, and had to put antibiotics in their eyes every 15 minutes for 2 days (even at night) to kill whatever it was eating them. I would say this is a major factor behind people being forced to visit their eye doctors more frequently.

In my wife’s words, “contacts all have different base curves so technically we need to make sure they fit ok”. Brands of contacts differ, especially at the comfort level. They also need to set correctly on your eyes, and if you have keratoconus or astigmatism, this can be extremely difficult and many pairs may need to be tried. On top of that, the eye doctor must see them on your eye to check how well they fit. I would guess this is where this law comes from.

For the record, my wife makes $0 for every pair of contacts she sells since she is an independent contractor. But that of course isn’t usually the case, and states do pass laws to protect their doctors. Here in Florida it is almost impossible to practice Optometry if you’ve been out of school more than 5 years - you would have to retake all of your boards, and their state exams, and you only get 3 attempts. In my opinion, this is to prevent the retired doctors from moving to the state and harming established practices, but I’m not 100% sure of that. I have heard of a case where an Optometrist who had diabetes and was the head of the Optometric board on diabetes failed the diabetic portion of the state boards (I believe it was in Arizona).

Prescriptions for glasses expire as well. I agree, it’s idiotic. I’ve been wearing glasses for 43 years; I know when I need a new prescription.

Well, that begins to clear things up.

The New Mexico Statutes include the following code section applicable to contact lens prescriptions:

There is a similar set of rules for opthalmic lenses (eyeglasses) in the prior section (10.3). You will notice that, while any prescription must include “the expiration date,” there is no requirement in the statute as to when that must be, or as to what fittings require. The full text of the laws can be found at this site.

Now, in addition to the statutes on the subject, there is a Board of Examiners in Optometry, established pursuant to NMS 61-2-5. This Board has issued a series of Rules which govern the practice of Optometry in the state of New Mexico. I wish I could give you a link to those rules, but the ones on FindLaw aren’t working tonight. You could try looking up links to the New Mexico Administrative Code yourself. One of those rules is the rule you referred to in your link, namely Rule 16.16.19, which establishes the fitting practices, etc.

This is common for a bureaucracy. The legislators don’t set very stringent requirements, but the people behind the rows of desks seek to protect you from all sorts of nefarious things, including, apparently, shoddy contact lens fitting. Presumably the Board’s rules also establish the two-year prescription limit, which, by the way, appears to be a common practice these days, as I had someone else last week have trouble getting a new pair of sunglasses because her prescription was more than two years old.

Cynical people might question why an eyeglass prescription needs to have an expiration date (I mean, other than to force you to see the optometrist, for fear that that outdated prescription is going to cause you serious harm :rolleyes: ). But the proper fitting does appear to have some good reasoning behind it, though one can question why it should be required, and not left to the discretion of the optometrist.

Anyway, that’s what is going on here, apparently. :slight_smile:

I would not be surprised to find the stringent rules were put into effect when contacts were a new invention back in the 1950s. That was also an era where consumerism hadn’t been invented yet & the attitude that the Establishment knows best was prevalent, especially in medicine.

Or an Urban Legend. I did a little research on some of those “Weird Laws” like you can’t hunt camels in Arizona, California guaranties sunshine to the masses, or everyone in Kentucky is require to bathe once a year and guess what: extremely few of those laws actually exist.

Incidently under Alaska Code Section 11.71.200, it is illegal to posess table salt.

This sounds like it could be it, though it’s not particularly satisfying: you can, without a doubt, feel it when contacts don’t fit properly on your eye, because it’s uncomfortable (I’ve done that when they botched my prescription once. Also when I once put my [vastly different] contacts in the wrong eyes.)

The expiration date thing does indeed seem to be lacking in a solid answer - again it seems to me the type of thing you notice on your own, if a change needs to be made. The whole thing reeks of “don’t trust the consumer” nonsense.

Incidentally, did you actually read the thread to see where the relevant laws are being discussed? :rolleyes:

I decided to get contacts for my wedding in 2000. I went in, they showed me how to put them in, I struggled with them for a week, I had called and asked if they should have been that uncomfortable, they said I was just messing with my eyes too much to get them in. I went back a week later, they looked at them on my eyes and couldn’t believe the person gave them to me, they were basically squeezing my eyes. My eyes were so messed up from wearing the wrong size for a week, I still can not tolerate having fans blowing on me and my eyes dry out badly. I get yellow blobs on the white part of my eye on the nose-side when they get irritated. I’ve been too afraid to try contacts since then.

It sounds like a damn good idea to me to force a recheck after a week. It’s what? 7 years later and I still have problems? If you are new to contacts, a week is probably too long, especially if there is a problem. A new user wouldn’t know necessarily what is a problem vs. what is normal acclimation.

It seems to me that this law is trying to strike a balance.

-The eye doc is not allowed to hold your prescription hostage forever.

-It answers the docs’ (genuine, or mercenary) concern of “we need to make sure the contacts are working out for the patient”.

A younger patient will have a fair range of accommodation. The reason for an expiration date on the prescription is to make sure the prescription is still valid after a couple of years. You might be seeing OK, yet needlessly straining your eyes to accommodate a prescription that is a bit off.

FWIW: My eye doc claims that the disposable lenses are thinner and less durable (but breathe better) than the non-disposable ones, but otherwise similar. Thus if cleaned and so forth, it is OK to keep using a set until they are physically damaged or lost (about equal chances in my case). I normally get around 6 months on a set, and have been doing that for at least 5 years. IANAOptometrist and this is my experience, not medical advice. Follow the advice of your professional care provider.

Um, explain how you reach that conlcusion about the Alaska Code Section? I reprint it for you here: